Dental Practice
Efficient Billing, Healthier Smiles: Your Dental
Practice's Revenue Partner
Dental Practice Billing
Billing in dental practices is a complex process that requires knowledge of medical coding, insurance policies, and compliance regulations. Unlike general medical billing, dental billing involves additional intricacies such as CDT (Current Dental Terminology) codes, cross-coding with CPT (Current Procedural Terminology) codes, managing both medical and dental insurance claims and meeting compliance regulations. These complexities make it difficult for in-house billing teams to maximize reimbursement and reduce claim denials.
In dental billing, challenges like claim denials, incorrect coding, and preauthorization delays can significantly impact a practice’s revenue. To help overcome these challenges, a professional medical billing company like us can provide the necessary expertise and dedicated resources to streamline billing operations, increase collections, and ensure compliance. By outsourcing billing solutions to us, your dental practice can reduce administrative burdens, improve cash flow, and enhance patient satisfaction.
Unbeatable Service, Quality & Price
ACCURACY
0
%
TURNAROUND TIME
<
0
Hours
COLLECTION
0
%
PRICE
Starting from $
1100
/Month
CHALLENGES
Challenges in Dental Practice Billing
Dual Insurance Processing (Medical and Dental): Many procedures performed by dentists and oral surgeons fall under medical insurance, but most in-house teams lack the expertise to properly bill medical insurance. Without proper cross-coding, practices lose significant reimbursement.
Incorrect Coding and Claim Denials: A major challenge in dental billing is incorrect use of CDT and CPT codes. If a procedure is incorrectly coded or lacks proper documentation, it leads to claim rejections or denials.
Bundling and Downcoding Issues: Insurance companies often bundle procedures, reducing reimbursements. Additionally, they may downcode procedures to a lower-paying code, requiring appeal and additional documentation.
OUR PROCESS
Our Dental Practice Billing Process Workflow
At RCM Workshop, the workflow process for dental practice billing involves several important steps to ensure accurate and timely reimbursement for services provided. It begins with patient registration where we collect and verify patient information and insurance details. Next, we assign appropriate CDT (Current Dental Terminology) and ICD-10 (International Classification of Diseases) codes to the rendered services and enter them into the billing system during charge entry to generate charges.
Following this, we submit the claims to insurance companies, ensuring that we include all necessary information to avoid denials. After that, we carry out payment posting where we record payments received from insurance companies and patients and reconcile them with the billed amounts. Then during denial management, we address and resolve any rejected claims, which may involve correcting errors or providing additional documentation. Finally, we carry out patient billing where we send bills to patients for any remaining balances after insurance payments, and during reporting and analysis, we regularly review billing reports to identify trends and improve the billing process.
Scheduling & Registration
Carry out well-coordinated appointment scheduling, update insurance details, and handle inbound and outbound calls from/to patients.
Eligibility & Benefits Verification
Confirm primary and secondary insurance and benefits coverage of patients and verify their coverage, co-pays, co-insurance, and deductibles.
Prior Authorization
Initiate request for prior authorization with the payer, follow up to check its status till closure and finally update the system with Auth approval reference number.
Medical Coding
Check the accuracy of codes and modifiers according to specialty and assign corresponding and appropriate charges to the codes.
Charge Posting
Enter the charges for the services provided into the billing system including the cost of the medication and the administration fee.
Claims Edits & Submission
Audit the claims thoroughly to check for accuracy and edit if necessary and submit claims – both EDI and paper format.
Payment Posting
Carry out both auto as well as manual posting for payments received and conduct reconciliation against claims.
Denial Management
Analyze and categorize denial claim according to denial codes, $ amount and payers, and resubmit claims after correction.
AR Management
Follow-up with payers to gather status for unpaid claims, and their resolution.
Patient Collection
Sending patient statements and follow-up with patients for final and outstanding payment.
You can confidently rely on us to manage your entire billing process, or you have the flexibility to select specific DME billing services that suit your needs, ensuring a seamless operation without any interruptions.
BENEFITS
Outcomes guaranteed
Our structured method for handling dental practice billing provides actionable insights to boost your ROI. We ensure adherence to the latest regulations and standards, keeping your center audit-ready and safeguarded from legal issues. Our team maintains the highest-quality standards, ensuring significantly enhanced financial results.
WHY US?
Why partner with us
Your dental practice can reap many benefits by partnering with us. Through efficient claims processing, we can improve your cash flow. You can free up in-house staff to increase operational efficiency and focus more on patient care. By getting better customer service, you can enhance patient satisfaction. Through our expertise in insurance negotiations, we can handle your complex claims more efficiently. This collaboration will allow your practice to run more smoothly and focus on providing excellent patient care.